A Retrospective Examination of Prandial Aspiration in Preterm Infants

2015 ◽  
Vol 24 (4) ◽  
pp. 162-174 ◽  
Author(s):  
Neina F. Ferguson ◽  
Julie Estis ◽  
Kelli Evans ◽  
Paul A. Dagenais ◽  
James VanHangehan
Keyword(s):  
Preterm Infants ◽  
Imaging Study ◽  
Bottle Feeding ◽  
Warning Signs ◽  
Oral Feeding ◽  
Clinical Judgments ◽  
Swallow Study ◽  
Design And Methods ◽  
Retrospective Examination ◽  
Upper Gastrointestinal

Purpose We conducted this retrospective study to identify potential signs of aspiration in preterm infants based on crib-side nursing documentation. Study Design and Methods A total of 2,590 bottle-feedings were examined for signs of distress across 41 preterm infants who were referred for a swallowing evaluation. All infants underwent either a videofluoroscopic swallow study (VSS) or upper gastrointestinal study (GIS). Physiologic and behavioral warning signs were coded across feedings 10 days prior to the imaging study. Presence or absence of documented aspiration during VSS/GIS was coded for each infant. Results Distress signs were documented in seven percent of oral feeding attempts. Aspiration was more common when the crib-side nurse documented coughing (LR+, 8.77; 95% CI, .99–77.09), compromised oxygen saturation levels (LR+, 2.15; CI, .86–5.47), and tachypnea (LR+, 2.15; CI, .28–3.01) during bottle-feeding. Clinical Implications Evidence-based distress signs that signal increased suspicion for prandial aspiration will facilitate correct clinical judgments at crib-side. Early identification and prevention of prandial aspiration improves health outcomes for preterm infants.

scholarly journals Bottle-Feeding Challenges in Preterm-Born Infants in the First 7 Months of Life

2020 ◽  
Vol 7 ◽  
pp. 2333794X2095268
Author(s):  
Rebecca R. Hill ◽  
Jinhee Park ◽  
Britt F. Pados
Keyword(s):  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Online Survey ◽  
Linear Models ◽  
Assessment Tool ◽  
Bottle Feeding ◽  
Oral Feeding ◽  
Term Infants ◽  
Very Preterm Infants ◽  
Preterm Born

Preterm infants frequently experience oral feeding challenges while in the neonatal intensive care unit, with research focusing on infant feeding during this hospital stay. There is little data on symptoms of problematic feeding in preterm-born infants in the months after discharge. The purpose of this study was to describe symptoms of problematic bottle-feeding in the first 7 months of life in infants born preterm, compared to full-term infants. Parents of infants less than 7 months old completed an online survey that included the Neonatal Eating Assessment Tool—Bottle-feeding and questions about the infant’s medical and feeding history. General linear models were used to evaluate differences in NeoEAT—Bottle-feeding total score and subscale scores by preterm category, considering other significant factors. Very preterm infants had more symptoms of problematic bottle-feeding than other infants. Current age, presence of gastroesophageal reflux, and anomalies of the face/mouth were associated with problematic bottle-feeding.

scholarly journals Evaluation of Syringe Feeding Compared to Bottle Feeding for the Transition from Gavage Feeding to Oral Feeding in Preterm Infants

2019 ◽  
Vol 6 (2) ◽  
pp. 94-98
Author(s):  
Birgül Say ◽  
Mehmet Büyüktiryaki ◽  
Nilüfer Okur ◽  
Gülsüm Kadıoğlu Şimşek ◽  
Fuat Emre Canpolat ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Bottle Feeding ◽  
Oral Feeding

scholarly journals Development of Swallowing Function in Infants with Oral Feeding Difficulties

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Changhun Han ◽  
Jaeho Shin ◽  
Ga Won Jeon
Keyword(s):  
Preterm Infants ◽  
Oral Feeding ◽  
Barium Swallow ◽  
Dietary Modification ◽  
Modified Barium Swallow ◽  
Feeding Difficulties ◽  
Swallowing Dysfunction ◽  
Swallow Study ◽  
Modified Barium Swallow Study ◽  
Swallow Therapy

Background. Discharge of preterm infants is often delayed because of their oral feeding difficulties. Independent oral feeding is the last obstacle to pass after managing acute and chronic morbidities. We conducted this study to determine the prevalence, characteristics, and risk factors of swallowing dysfunction and suggest proper interventions to reduce aspiration and chronic lung injury. Methods. Infants admitted to the neonatal intensive care unit (January 2016 to December 2018) who were performed modified barium swallow study due to oral feeding difficulties were enrolled. Modified barium swallow study was done≥postmenstrual age 37 weeks to limit radiation exposure. Clinical data were collected retrospectively. Swallowing dysfunction was defined as inadequate epiglottic closure, laryngeal penetration, or tracheal aspiration according to result of the modified barium swallow study. Results. Among a total of 54 infants enrolled, nine (16.7%) were term infants, 13 (24.1%) were late preterm infants (gestational age, 34-36 weeks), and 32 (59.3%) were early preterm infants (gestational age<34 weeks). Gestational age and birth weight were smaller in infants with swallowing dysfunction. Total duration of mechanical ventilation and duration of invasive ventilation were longer in infants with swallowing dysfunction. The risk of swallowing dysfunction increased by 11.2 times for infants with gestational age<29 weeks compared to infants with gestational age≥29 weeks. Swallowing dysfunction was improved in most infants after they became matured. They showed different time and rate of maturation with the help of rehabilitation through swallow therapy and dietary modification with thickened formula. Conclusion. Preterm infants with gestational age<29 weeks or with longer ventilation duration are at a higher risk of aspiration. Rehabilitation of swallow therapy and dietary modification with thickened formula can be helpful interventions to prevent aspiration and chronic lung injury and reassure parents until independent oral feeding is possible.

scholarly journals A New Bottle Design Decreases Hypoxemic Episodes during Feeding in Preterm Infants

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Alejandro Jenik ◽  
Carlos Fustiñana ◽  
Maritza Marquez ◽  
David Mage ◽  
Gloria Fernandez ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Preterm Infants ◽  
Bottle Feeding ◽  
Oral Feeding ◽  
Milk Intake ◽  
The Other ◽  
Intake Rate ◽  
Feeding Performance ◽  
Time Of Feeding ◽  
Efficiency Rate

Oxygen saturation is lower during bottle feeding than during breastfeeding in preterm infants. Our objective was to compare two different bottle systems in healthy preterm infants before discharge in terms of SpO2and oral feeding efficiency (rate of milk intake). Infants without supplement oxygen needs were evaluated twice on the same day during two consecutive feeds, by the same nurse. Infants served as their own controls for comparison of two systems of bottles, the order of which was randomized. The new bottle's nipple design mimics mom's breast in shape and feel, and the bottle vents to air when the child sucks on the nipple. The other system was the hospital's standard plastic bottle with silicone nipple. The rate of milk intake was calculated as the total volume transferred minus volume lost divided by time of feeding, mL/min. Thirty-four infants (BW:1,163±479.1 g) were studied at35.4±1.3weeks after-conception. SpO2was significantly higher in infants fed with the new bottle design. Milk intake rate was significantly higher with the new bottle than with the standard bottle design. The new bottle design improves oral feeding performance in preterm infants near to discharge when compared to that of a standard bottle.

scholarly journals Safety of Bottle-Feeding Under Nasal Respiratory Support in Preterm Lambs With and Without Tachypnoea

2022 ◽  
Vol 12 ◽  
Author(s):  
Basma Fathi Elsewadi ◽  
Nathalie Samson ◽  
Charlène Nadeau ◽  
Kristien Vanhaverbeke ◽  
Nam Nguyen ◽  
...  
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Preterm Infants ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
High Flow ◽  
Bottle Feeding ◽  
Oral Feeding ◽  
Respiratory Support ◽  
Or Efficiency ◽  
Tracheal Pressure

Aim: Convalescing preterm infants often require non-invasive respiratory support, such as nasal continuous positive airway pressure or high-flow nasal cannulas. One challenging milestone for preterm infants is achieving full oral feeding. Some teams fear nasal respiratory support might disrupt sucking–swallowing–breathing coordination and induce severe cardiorespiratory events. The main objective of this study was to assess the safety of oral feeding of preterm lambs on nasal respiratory support, with or without tachypnoea.Methods: Sucking, swallowing and breathing functions, as well as electrocardiogram, oxygen haemoglobin saturation, arterial blood gases and videofluoroscopic swallowing study were recorded in 15 preterm lambs during bottle-feeding. Four randomly ordered conditions were studied: control, nasal continuous positive airway pressure (6 cmH2O), high-flow nasal cannulas (7 L•min–1), and high-flow nasal cannulas at 7 L•min–1 at a tracheal pressure of 6 cmH2O. The recordings were repeated on days 7–8 and 13–14 to assess the effect of maturation.Results: None of the respiratory support impaired the safety or efficiency of oral feeding, even with tachypnoea. No respiratory support systematically impacted sucking–swallowing–breathing coordination, with or without tachypnoea. No effect of maturation was found.Conclusion: This translational physiology study, uniquely conducted in a relevant animal model of preterm infant with respiratory impairment, shows that nasal respiratory support does not impact the safety or efficiency of bottle-feeding or sucking–swallowing–breathing coordination. These results suggest that clinical studies on bottle-feeding in preterm infants under nasal continuous positive airway pressure and/or high-flow nasal cannulas can be safely undertaken.

scholarly journals Early skin contact combined with mother’s breastfeeding to shorten the process of premature infants ≤ 30 weeks of gestation to achieve full oral feeding: the study protocol of a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Liling Li ◽  
Li Wang ◽  
Conway Niu ◽  
Chan Liu ◽  
Tianchan Lv ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Preterm Infants ◽  
Premature Infants ◽  
Gestational Age ◽  
Training Model ◽  
Bottle Feeding ◽  
Oral Feeding ◽  
Single Center ◽  
Randomized Controlled ◽  
Skin Contact

Abstract Background Most hospitalized preterm infants experience difficulties in transitioning from tube feeding to full oral feeding. Interventions to promote full oral feeding in preterm infants in the neonatal intensive care unit (NICU) are limited to pacifier use or bottle-feeding exercises. Skin contact has been shown to be beneficial to start and maintain lactation and provide preterm infants with the opportunity to suck on the mother’s breast, which may promote further development of the preterm infant’s suckling patterns. The objective of this study is to compare and evaluate the effects of skin contact combined with breastfeeding (suck on the mother’s empty breast) as compared to the routine pacifier suckling training model in achieving full oral feeding for infants whose gestational age are ≤ 30 weeks. Methods This is a single-center, randomized controlled clinical trial conducted in the NICU and designed according to the SPIRIT Statement. The subjects included in the study are premature infants born between April 2020 and July 2021 with a gestational age of ≤30 weeks, birth weight of <1500 g, admission age of <72 h, and absence of congenital malformations. Those with oxygenation indices of >40 and those born to mothers with poor verbal communication skills will be excluded. A sample of 148 infants is needed. The infants will be randomized to the intervention (skin contact combined with mother’s breastfeeding model) or control group (routine pacifier sucking training model). The primary outcome is the time required to achieve full oral feeding. The secondary outcomes are the breastfeeding abilities of preterm infants as assessed by the Preterm Infant Breastfeeding Behavior Scale (PIBBS), breastfeeding rates at 3 and 6 months corrected gestational age, complication rates, duration of oxygen requirement, days of hospital stay, and satisfaction of parents. Discussion This paper describes the first single-center, open-label, randomized clinical trial on this topic and will provide crucial information to support the implementation of skin contact combined with the breastfeeding model in the NICU setting. Trial registration ClinicalTrials.gov NCT 04283682. Registered on 8 February 2020.

The Effect of Individualized Developmental Care Practices in Preterm Infants

2019 ◽  
Vol 27 (2) ◽  
pp. 97-104
Author(s):  
Dilek Küçük Alemdar ◽  
Sevil İnal
Keyword(s):  
Breast Milk ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Controlled Trial ◽  
Oral Feeding ◽  
Control Group ◽  
Developmental Care ◽  
Significant Difference ◽  
Care Practices ◽  
Maternal Voice

Background: Preterm infants are vulnerable humans requiring much care and attention. They may be exposed to irregular noise, light, and odor in the neonatal intensive care unit for a period of several weeks or months. This study was carried out to determine the effect of individualized developmental care on physiological parameters, growth, and transition to oral feeding in preterm infants. Methods: The study was a randomized controlled trial. The sample comprised premature infants meeting the inclusion criteria. They were randomly assigned to four groups: the maternal voice group, the breast milk odor (BMO) group, the incubator cover (IC) group, and the control group. Results: No statistically significant difference was found between the groups in terms of weight, height, and head circumference at time of discharge. Mean SO2 values were statistically higher in the IC group than the other groups; however, the heart rate and respiratory rate were not statistically different in a significant sense between the groups. The briefest duration of transition to total oral feeding was seen in the BMO group. Conclusion: Individualized developmental care practices based on the results of these interventions are likely to support the care of preterm infants. Breast milk odor may ease the transition to breastfeeding.

A feeding protocol for healthy preterm infants that shortens time to oral feeding

2001 ◽  
Vol 139 (3) ◽  
pp. 374-379 ◽  
Author(s):  
Gail C. McCain ◽  
Peter S. Gartside ◽  
James M. Greenberg ◽  
Judy Wright Lott
Keyword(s):  
Preterm Infants ◽  
Oral Feeding ◽  
Feeding Protocol

Effect of Oral Motor Intervention on Oral Feeding in Preterm Infants: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-11
Author(s):  
Danna Chen ◽  
Zhen Yang ◽  
Chujie Chen ◽  
Pu Wang
Keyword(s):  
Weight Gain ◽  
Hospital Stay ◽  
Preterm Infants ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Oral Feeding ◽  
Transition Time ◽  
Cochrane Library ◽  
Oral Motor ◽  
Feeding Efficiency

Objective This review article aimed to explore the effect of oral motor intervention on oral feeding in preterm infants through a meta-analysis. Method Eligible studies were retrieved from four databases (PubMed, Embase, Cochrane Library, and Web of Science) up to July 2020 and screened based on established selection criteria. Thereafter, relevant data were extracted and heterogeneity tests were conducted to select appropriate effect models according to the chi-square test and I 2 statistics. Assessment of risk of bias was performed among the included studies. Finally, a meta-analysis was carried out to evaluate the effect of oral motor intervention in preterm infants according to four clinical indicators: transition time for oral feeding, length of hospital stay, feeding efficiency, and weight gain. Results Eighteen randomized controlled trials with 848 participants were selected to evaluate the effect of oral motor intervention on preterm infants. The meta-analysis results revealed that oral motor intervention could effectively reduce the transition time to full oral feeds and the length of hospital stay as well as increase feeding efficiency and weight gain. Conclusions Oral motor intervention was an effective way to improve oral feeding in preterm infants. It is worthy to be used widely in hospitals to improve the clinical outcomes of preterm infants and reduce the economic burdens of families and society. Future studies should seek to identify detailed intervention processes and intervention durations for clinical application.

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